Do Postoperative Radiochemotherapy and/or Aggressive Chemotherapy for Patients with Cancer of the Esophagus Who Have Undergone Curative Surgery Contribute to Improvement of Prognosis?

  • Tetsuro Nishihira
  • Katsu Hirayama
  • Takashi Akaishi
  • Ryuzaburo Shineha
  • Masabumi Katayama
  • Norio Higuchi
  • Shozo Mori
Conference paper


The most frequent sites of tumors after curative surgery of the thoracic esophagus are in the cervical region and/or mediastinum. Detailed analysis of 187 cases in our hospital showed that postoperative adjuvant therapy, namely, radiochemoimmunotherapy, improved the survival rate of patients undergoing such surgery. This indicates that such therapy prevents the recurrence of micrometastasis after curative surgery. However, the prognosis of patients with positive nodes did not improve, in spite of extensive radical surgery including lymph-adenectomy. In order to improve the prognosis in such cases with positive regional nodes, a newly devised protocol of radiochemocytokine therapy including tumor necrosis factor (TNF), interleukin 2 (IL-2) and a-interferon (α-INF) has recently been performed. For patients with distant node metastasis, conventional postoperative aggressive chemotherapy under active nutritional support has been found to prolong survival. The 5-year survival rate of patients treated with aggressive chemotherapy and radiochemocytokine therapy was analyzed.


Esophageal Cancer Curative Surgery Thoracic Esophagus Postoperative Adjuvant Therapy Aggressive Chemotherapy 
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  1. 1.
    Kasai M, Mori S, Watanabe T (1978) Follow-up results after resection of thoracic esoph-ageal carcinoma. World J Surg 2: 543–551PubMedCrossRefGoogle Scholar
  2. 2.
    Nishihira T, Hirayama K, Kitamura M, Shineha R, Akaishi T, Mori S (1989) Postoperative radio-cytokine therapy for patients with cancer of the esophagus involving regional node metastasis who have undergone curative surgery. In: Proceedings of the 33rd world congress of the International Society of Surgery, Toronto, October 1989, p 92Google Scholar
  3. 3.
    Nishihira T, Tan M, Kuriya Y, Ohmori N, Kitamura M, Toyoda T, Kasai M (1984) Postoperative cancer therapy for patients with carcinoma of the thoracic esophagus: an attempt of aggressive chemotherapy combined with proper nutritional support for patients with distant node metastasis. Tohoku J Exp Med 142: 25–34PubMedCrossRefGoogle Scholar
  4. 4.
    Nishihira T, Hirayama K, Shineha T, Akaishi T, Takano R, Kitamura M, Mori M (1990) Postoperative adjuvant therapies for cancer of the thoracic esophagus on the basis of the extent of node metastasis. La Chirurgia Toracica 43 (1): 4–12Google Scholar
  5. 5.
    Nishihira T, Watanabe T, Ohmori N, Kasai M (1984) Long-term evaluation of patients treated by radical operation for carcinoma of the thoracic esophagus. World J Surg. 8: 778–785PubMedCrossRefGoogle Scholar
  6. 6.
    Nishihira T, Hirayama K, Kitamura M, Akaishi T, Shineha R, Sekine Y, Kasai M (1989) Postoperative aggressive chemotherapy with nutritional support in case of thoracic esophageal cancer with distant lymph-node metastasis. In: Kimura K (ed) Cancer chemotherapy: Challenges for the future. Excerpta Medica, Tokyo, pp 165–173Google Scholar
  7. 7.
    Nishihira T, Akaishi T, Shineha R, Sekine Y, Sanekata K, Hirayama K, Sagawa J, Takano R, Mori S (1989) Malignant potential of esophageal carcinoma in terms of biological properties. Dis esoph 11 (2): 125–135Google Scholar
  8. 8.
    Hiraizumi S, Takasaki S, Nishihira T, Mori S, Kobata A (1990) Comparative study of the N-linked oligosaccharides released from normal human esophageal epithelium and esophageal squamous carcinoma. Jpn J Cancer Res 81: 363–371PubMedCrossRefGoogle Scholar
  9. 9.
    Nishihira T, Kasai M, Kitamura M, Hirayama K, Akaishi T, Sekine Y (1988) Biological characteristics of cultured cell lines of human esophageal carcinomas and tumors transplantable to nude mice originating from human esophageal carcinomas and their clinical application. In: Webber MM (ed) In vitro models for cancer research, vol 1. Carcinomas of the esophagus and colon. Florida, CRC, Boca Raton, pp 66–79Google Scholar
  10. 10.
    Tsuda T, Nakatani H, Matsumura T, Yoshida K, Tahara E, Nishihira T, Sakamoto H, Yoshida T, Terada M, Sugimura T (1988) Amplification of the hst-1 gene in human esophageal carcinomas. Jpn J Cancer Res 79: 584–588PubMedCrossRefGoogle Scholar
  11. 11.
    Takano R, Nose M, Nishihira T, Kyogoku M (1990) Increase of 1–6-branched oligo-saccharides in human esophageal carcinomas invasive against surrounding tissue in vivo and in vitro. Am J Path 137 (5): 1007–1011PubMedGoogle Scholar

Copyright information

© Springer-Verlag Tokyo 1993

Authors and Affiliations

  • Tetsuro Nishihira
  • Katsu Hirayama
  • Takashi Akaishi
  • Ryuzaburo Shineha
  • Masabumi Katayama
  • Norio Higuchi
  • Shozo Mori
    • 1
  1. 1.Second Department of SurgeryTohoku University School of MedicineSendai, 980Japan

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